平均血小板体积/淋巴细胞比值与老年非瓣膜性心房颤动患者左心房血栓形成的关系  

Relationship between mean platelet volume/lymphocyte ratio and left atrial thrombosis in elderly patients with nonvalvular atrial fibrillation

作　　者：李斌 王锦春[1] 王志斌 张斌[3] 毛亚兰 张亚奇 LI Bin;WANG Jinchun;WANG Zhibin;ZHANG Bin;MAO Yalan;ZHANG Yaqi(Department of Clinical Laboratory,Tianshui Integrated Traditional Chinese and Western Medicine Hospital,Tianshui,Gansu 741020,China;Department of Ultrasound,Tianshui Integrated Traditional Chinese and Western Medicine Hospital,Tianshui,Gansu 741020,China;Department of Geriatrics,Tianshui Integrated Traditional Chinese and Western Medicine Hospital,Tianshui,Gansu 741020,China;Department of Nephrology,Tianshui Integrated Traditional Chinese and Western Medicine Hospital,Tianshui,Gansu 741020,China;Department of Oncology,Tianshui Integrated Traditional Chinese and Western Medicine Hospital,Tianshui,Gansu 741020,China)

机构地区：[1]天水市中西医结合医院检验科,甘肃天水741020 [2]天水市中西医结合医院超声科,甘肃天水741020 [3]天水市中西医结合医院老年病科,甘肃天水741020 [4]天水市中西医结合医院肾病科,甘肃天水741020 [5]天水市中西医结合医院肿瘤科,甘肃天水741020

出　　处：《国际检验医学杂志》2024年第6期681-685,共5页International Journal of Laboratory Medicine

基　　金：甘肃省科技计划项目——创新基地和人才计划(21JR1RA068)。

摘　　要：目的探讨平均血小板体积/淋巴细胞比值(MPVLR)与老年非瓣膜性心房颤动(NVAF)患者左心房血栓形成的关系。方法将2019年1月至2022年12月该院收治的178例老年NVAF患者纳入研究。根据食管超声心动图(TEE)判断患者左心房血栓形成情况,将患者分为血栓组(28例)和非血栓组(150例)。采用全自动血细胞分析仪检测白细胞计数(WBC)、红细胞计数(RBC)、淋巴细胞计数、淋巴细胞比例、血小板计数(PLT)、平均血小板体积(MPV)并计算MPVLR。采用全自动生化分析仪检测肝、肾功能指标及血脂指标。采用受试者工作特征(ROC)曲线评估MPV、淋巴细胞比例、MPVLR对NVAF患者左心房血栓形成的预测价值。采用多因素Logistic回归分析老年NVAF患者左心房血栓形成的影响因素。结果血栓组MPV、淋巴细胞比例、MPVLR均高于非血栓组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,MPV、淋巴细胞比例、MPVLR预测NVAF患者左心房血栓形成的曲线下面积(AUC)分别为0.821(95%CI:0.764~0.882)、0.771(95%CI:0.714~0.842)、0.901(95%CI:0.861~0.949)。血栓组病程长于非血栓组,有慢性心力衰竭者比例、有脑卒中者比例、CHA2DS2-VASc评分、LAEF、LAD、LVEDV、MPVLR、血尿酸、MPV、淋巴细胞比例、MPVLR均高于非血栓组,LVEF低于非血栓组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,病程≥1.93年(OR=3.050,95%CI:1.928~4.824)、慢性心力衰竭(OR=3.333,95%CI:1.808~6.144)、MPVLR≥3.10(OR=3.873,95%CI:1.734~8.650)是老年NVAF患者左心房血栓形成的独立危险因素(P<0.05)。结论MPVLR升高与老年NVAF患者左心房血栓形成存在关联,可作为预测患者左心房血栓形成的指标。Objective To investigate the relationship between mean platelet volume/lymphocyte ratio(MPVLR)and left atrial thrombosis in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 178 elderly patients with NVAF admitted to the hospital from January 2019 to December 2022 were enrolled in the study.The patients were divided into thrombosis group(28 cases)and non-thrombosis group(150 cases)according to the left atrial thrombosis judged by using esophageal echocardiography(TEE).The white blood cell count(WBC),red blood cell count(RBC),lymphocyte count,lymphocyte proportion,platelet count(PLT)and mean platelet volume(MPV)were detected by automatic blood cell analyzer,and MPVLR was calculated.The liver and kidney function indicators and blood lipid indicators were detected by automatic biochemical analyzer.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of MPV,lymphocyte ratio and MPVLR for left atrial thrombosis in NVAF patients.Multivariate Logistic regression was used to analyze the influencing factors of left atrial thrombosis in elderly NVAF patients.Results MPV,lymphocyte proportion and MPVLR in the thrombosis group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of MPV,lymphocyte ratio and MPVLR for predicting left atrial thrombosis in NVAF patients were 0.821(95%CI:0.764-0.882),0.771(95%CI:0.714-0.842)and 0.901(95%CI:0.861-0.949),respectively.The course of disease in the thrombosis group was longer than that in the non-thrombosis group,the proportion of patients with chronic heart failure,the proportion of patients with stroke,CHA2DS2-VASc score,LAEF,LAD,LVEDV,MPVLR,serum uric acid,MPV,lymphocyte proportion and MPVLR were higher than those in the non-thrombosis group,and LVEF was lower than that in the non-thrombosis group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that

关 键 词：平均血小板体积/淋巴细胞比值 老年 非瓣膜性房颤 左心房血栓 

分 类 号：R446.11[医药卫生—诊断学]